Clinical, epidemiological, and microbiological features of Vibrio vulnificus biogroup 3 causing outbreaks of wound infection and bacteraemia in Israel
Clinical, epidemiological, and microbiological features of Vibrio vulnificus biogroup 3 causing outbreaks of wound infection and bacteraemia in Israel
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DOI：
10.1016/s0140-6736(99)02471-x
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发表时间：
1999-10-23
期刊：
影响因子：
168.9
通讯作者：
Farmer, JJ
中科院分区：
文献类型：
--
作者：
Bisharat, N;Agmon, V;Farmer, JJ
研究背景创伤弧菌是一种引起败血症和伤口感染的革兰氏阴性细菌。病例是零星发生的，以前没有报告过因共同来源或克隆性菌株引起的暴发。1996年和1997年夏秋两季，以色列发生了一起新近接触人工鱼塘新鲜全鱼的创伤弧菌侵袭性感染事件。方法回顾临床和流行病学资料，并进行环境调查，评估疾病特征、传播方式、细菌表型特征和鱼类营销政策。采用生物分型、脉冲场凝胶电泳法和限制性片段长度多态分析(RFLP)对19株细菌的克隆性进行了研究。57例发生蜂窝织炎，4例发生坏死性筋膜炎，1例发生骨髓炎。在所有情况下，这些鱼都是在内陆鱼塘养殖的。1996年夏天，鱼塘管理者启动了一项新的营销政策，将鱼活生生地出售，而不是装在冰块里。从表型上看，这些分离物有五个非典型的生化试验结果。这些分离株经脉冲场凝胶电泳法不能分型，并且都具有以前从未见过的相同的PCR-RFLP图谱。据解释，暴发的原因是一种新的创伤弧菌，被归类为生物组3。1996年开始的一项新的鱼类营销政策可能使易感人群接触到这种生物。
Background Vibrio vulnificus is a gram-negative bacterium that causes septicaemia and wound infection. Cases occur sporadically, and no previous outbreaks due to a common source or a clonal strain have been reported. In the summer and autumn of 1996 and 1997, an outbreak of invasive V vulnificus infection occurred in Israel in people who had recently handled fresh, whole fish purchased from artificial fish-ponds.Methods We reviewed clinical and epidemiological information, and undertook an environmental investigation to assess disease characteristics, modes of transmission, phenotypic characteristics of the bacterium, and fish-marketing policy. The clonal nature of 19 isolates was studied by biotyping, pulsed-field gel electrophoresis, and restriction-fragment length polymorphism (RFLP) analysis of a PCR fragment.Findings During 1996-97, 62 cases of wound infection and bacteraemia occurred. 57 patients developed cellulitis, four had necrotising fasciitis, and one developed osteomyelitis. In all cases, the fish were cultivated in inland fish-ponds. In the summer of 1996, fish-pond managers initiated a new marketing policy, in which fish were sold alive instead of being packed in ice. Phenotypically, the isolates had five atypical biochemical test results. The isolates were non-typeable by pulsed-field gel electrophoresis, and all had the same PCR-RFLP pattern which had not been seen previously.Interpretation The cause of the outbreak was a new strain of V vulnificus, classified as biogroup 3. A new fish-marketing policy that began in 1996 may have exposed susceptible people to the organism.